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Вопросы вирусологии. 2018; 63: 261-267

МЕЗЕНХИМАЛЬНЫЕ СТВОЛОВЫЕ КЛЕТКИ: УСИЛЕНИЕ ИММУННОГО ОТВЕТА И ЗАЩИТА МЫШЕЙ ОТ ЛЕТАЛЬНОЙ ГЕРПЕСВИРУСНОЙ ИНФЕКЦИИ

Климова Р. Р., Момотюк Е. Д., Демидова Н. А., Ярыгина Е. И., Кущ А. А.

https://doi.org/10.18821/0507-4088-2018-63-6-261-267

Аннотация

Цель настоящей работы состояла в оценке иммунорегуляторных и протективных свойств мезенхимальных стволовых клеток (МСК) на экспериментальной модели летальной ВПГ-1-инфекции (вирус простого герпеса 1-го типа) мышей. МСК получали из костного мозга мышей линии DBA и высаживали в культуральные флаконы в среде DMEM, содержащей 10% эмбриональной телячьей сыворотки, инсулин, трансферрин, селенит, фактор роста фибробластов, глутамин и гентамицин. Прикрепившиеся клетки пассировали, на каждом пассаже отбирали культуральную жидкость (к/ж) и изучали противовирусную активность на клетках Vero, заражённых ВПГ-1. В опытах in vivo использовали 5 групп по 10 мышей DBA: 1-я группа - интактные (naïve); 2-я - внутривенное (в/в) введение МСК; 3-я - заражение 20 полулетальными дозами (ЛД50) ВПГ-1 внутрибрюшинно с последующим в/в введением МСК; 4-я - заражение ВПГ-1 с последующим введением ацикловира (АЦВ); 5-я - заражение ВПГ-1 и в/в введение физиологического раствора. Показано, что выделенные клетки по морфологии, адгезивной способности и поверхностным рецепторам соответствовали общепринятым характеристикам МСК. Установлено, что к/ж от МСК на 4-5-м пассажах подавляла ВПГ-1-инфекцию in vitro на 64-70%, и в то же время в к/ж были обнаружены ИЛ-6 и ФНО-α, концентрация которых на 3-4-м пассажах в 5 и 20 раз соответственно превышала контрольный уровень. При введении заражённым ВПГ-1 мышам 3-й группы МСК выживаемость составила 70%, ацикловира - 60%, что значимо превышало число выживших животных (10%) в контрольной 5-й группе. У выживших животных 3-й группы обнаружена высокая активность вируснейтрализующих антител к ВПГ-1, а также активация пролиферации Т-клеток. У выживших мышей 3-й группы уровни ИЛ-6 и ФНО-α оказались ниже, а ИФН-γ - значительно выше по сравнению с таковыми у агонизирующих животных этой группы (р < 0,05). Таким образом впервые показано, что клеточная терапия МСК является перспективным подходом к разработке новых эффективных методов лечения генерализованной ВПГ-1-инфекции.
Список литературы

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5. Ma S., Xie N., Li W., Yuan B., Shi Y., Wang Y. Immunobiology of mesenchymal stem cells. Cell Death Differ. 2014; 21(2): 216-25.

6. Rohban R., Pieber T.R. Mesenchymal Stem and Progenitor Cells in Regeneration: Tissue Specificity and Regenerative Potential. Stem Cells Int. 2017; 2017: 5173732.

7. Rivera-Cruz C.M., Shearer J.J., Figueiredo Neto M., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: e4015039.

8. Darwish I., Banner D., Mubareka S., Kim H., Besla R., Kelvin D.J., et al. Mesenchymal stromal (stem) cell therapy fails to improve outcomes in experimental severe influenza. PLoS One. 2013; 8(8): e71761.

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10. Климова Р.Р., Момотюк Е.Д., Демидова Н.А., Чернорыж Я.Ю., Коваль В.С., Иванов А.А. и др. Димерные бисбензимидазолы подавляют инфекции, вызванные вирусом простого герпеса и цитомегаловирусом человека, в клеточных культурах. Вопросы вирусологии. 2017; 62(4): 162-8

11. Dominici M., LeBlanc K., Mueller I., Slaper-Cortenbach I., Marini F., Krause D., et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006; 8(4): 315-7.

12. Ellermann-Eriksen S. Macrophages and cytokines in the early defence against herpes simplex virus. Virol. J. 2005; 2: 59.

13. Riediger C., Sauer P., Matevossian E., Müller M.W., Büchler P., Friess H. Herpes simplex virus sepsis and acute liver failure. Clin. Transpl. 2009; 23(Suppl. 21): 37-41.

14. Rozenberg F., Deback C., Agut H. Herpes simplex encephalitis: from virus to therapy. Infect. Disord. Drug Targets. 2011; 11(3): 235-50.

15. Cagliani J., Grande D., Molmenti E.P., Miller E.J., Rilo H.L.R. Immunomodulation by Mesenchymal Stromal Cells and Their Clinical Applications. J. Stem Cell Regen. Biol. 2017; 3(2).

16. Kyurkchiev D., Bochev I., Ivanova-Todorova E., Mourdjeva M., Oreshkova T., Belemezova K., et al. Secretion of immunoregulatory cytokines by mesenchymal stem cells. World J Stem Cells. 2014; 6(5): 552-70.

17. Whitley R. J. Herpes Simplex Viruses. In: Knipe D.M., Howley P.M., eds. Fields Virology. Volume 2. Philadelphia, PA: Lippincott Williams and Wilkins; 2001: 2461-509.

18. Di Nicola M., Carlo-Stella C., Magni M., Milanesi M., Longoni P.D., Matteucci P., et al. Human bone marrow stromal cells suppress T-lymphocyte proliferation induced by cellular or nonspecific mitogenic stimuli. Blood. 2002; 99(10): 3838-43.

19. Rosado M.M., Bernardo M.E., Scarsella M., Conforti A., Giorda E., Biagini S., et al. Inhibition of B-cell proliferation and antibody production by mesenchymal stromal cells is mediated by T cells. Stem Cells Dev. 2015; 24(1): 93-103.

20. Rivera-Cruz C.M., Shearer J.J., Neto M.F., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: 4015039.

21. Bian P., Ye C., Zheng X., Yang J., Ye W., Wang Y., et al. Mesenchymal stem cells alleviate Japanese encephalitis virus-induced neuroinflammation and mortality. Stem Cell Res Ther. 2017; 8(1): 38.

22. Chan M.C., Kuok D.I., Leung C.Y., Hui K.P., Valkenburg S.A., Lau E.H., et al. Human mesenchymal stromal cells reduce influenza A H5N1-associated acute lung injury in vitro and in vivo. Proc. Natl. Acad. Sci. 2016; 113(13): 3621-6.

23. Zhang Z., Fu J., Xu X., Wang S., Xu R., Zhao M., et al. Safety and immunological responses to human mesenchymal stem cell therapy in difficult-to-treat HIV-1-infected patients. AIDS. 2013; 27(8): 1283-93.

24. Arduino P.G., Porter S.R. Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features. J. Oral. Pathol. Med. 2008; 37(2): 107-21.

25. Looker K.J., Magaret A.S., May M.T., Turner K.M., Vickerman P., Gottlieb S.L., et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One. 2015; 10(10): e0140765.

26. James S.H., Kimberlin D.W. Neonatal Herpes Simplex Virus Infection. Infect. Dis. Clin. North Am. 2015; 29(3): 391-400.

27. Ruffner M.A., Sullivan K.E., Henrickson S.E. Recurrent and Sustained Viral Infections in Primary Immunodeficiencies. Front. Immunol. 2017; 8: 665.

28. Ma S., Xie N., Li W., Yuan B., Shi Y., Wang Y. Immunobiology of mesenchymal stem cells. Cell Death Differ. 2014; 21(2): 216-25.

29. Rohban R., Pieber T.R. Mesenchymal Stem and Progenitor Cells in Regeneration: Tissue Specificity and Regenerative Potential. Stem Cells Int. 2017; 2017: 5173732.

30. Rivera-Cruz C.M., Shearer J.J., Figueiredo Neto M., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: e4015039.

31. Darwish I., Banner D., Mubareka S., Kim H., Besla R., Kelvin D.J., et al. Mesenchymal stromal (stem) cell therapy fails to improve outcomes in experimental severe influenza. PLoS One. 2013; 8(8): e71761.

32. Li Y., Xu J., Shi W., Chen C., Shao Y., Zhu L., et al. Mesenchymal stromal cell treatment prevents H9N2 avian influenza virus-induced acute lung injury in mice. Stem Cell. Res. Ther. 2016; 7(1): 159.

33. Klimova R.R., Momotyuk E.D., Demidova N.A., Chernoryzh Ya.Yu., Koval’ V.S., Ivanov A.A., et al. Dimeric bisbenzimidazoles suppress the herpes simplex virus and human cytomegalovirus infections in the cells in vitro. Voprosy virusologii. 2017; 62(4): 162-8. (in Russian)

34. Dominici M., LeBlanc K., Mueller I., Slaper-Cortenbach I., Marini F., Krause D., et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006; 8(4): 315-7.

35. Ellermann-Eriksen S. Macrophages and cytokines in the early defence against herpes simplex virus. Virol. J. 2005; 2: 59.

36. Riediger C., Sauer P., Matevossian E., Müller M.W., Büchler P., Friess H. Herpes simplex virus sepsis and acute liver failure. Clin. Transpl. 2009; 23(Suppl. 21): 37-41.

37. Rozenberg F., Deback C., Agut H. Herpes simplex encephalitis: from virus to therapy. Infect. Disord. Drug Targets. 2011; 11(3): 235-50.

38. Cagliani J., Grande D., Molmenti E.P., Miller E.J., Rilo H.L.R. Immunomodulation by Mesenchymal Stromal Cells and Their Clinical Applications. J. Stem Cell Regen. Biol. 2017; 3(2).

39. Kyurkchiev D., Bochev I., Ivanova-Todorova E., Mourdjeva M., Oreshkova T., Belemezova K., et al. Secretion of immunoregulatory cytokines by mesenchymal stem cells. World J Stem Cells. 2014; 6(5): 552-70.

40. Whitley R. J. Herpes Simplex Viruses. In: Knipe D.M., Howley P.M., eds. Fields Virology. Volume 2. Philadelphia, PA: Lippincott Williams and Wilkins; 2001: 2461-509.

41. Di Nicola M., Carlo-Stella C., Magni M., Milanesi M., Longoni P.D., Matteucci P., et al. Human bone marrow stromal cells suppress T-lymphocyte proliferation induced by cellular or nonspecific mitogenic stimuli. Blood. 2002; 99(10): 3838-43.

42. Rosado M.M., Bernardo M.E., Scarsella M., Conforti A., Giorda E., Biagini S., et al. Inhibition of B-cell proliferation and antibody production by mesenchymal stromal cells is mediated by T cells. Stem Cells Dev. 2015; 24(1): 93-103.

43. Rivera-Cruz C.M., Shearer J.J., Neto M.F., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: 4015039.

44. Bian P., Ye C., Zheng X., Yang J., Ye W., Wang Y., et al. Mesenchymal stem cells alleviate Japanese encephalitis virus-induced neuroinflammation and mortality. Stem Cell Res Ther. 2017; 8(1): 38.

45. Chan M.C., Kuok D.I., Leung C.Y., Hui K.P., Valkenburg S.A., Lau E.H., et al. Human mesenchymal stromal cells reduce influenza A H5N1-associated acute lung injury in vitro and in vivo. Proc. Natl. Acad. Sci. 2016; 113(13): 3621-6.

46. Zhang Z., Fu J., Xu X., Wang S., Xu R., Zhao M., et al. Safety and immunological responses to human mesenchymal stem cell therapy in difficult-to-treat HIV-1-infected patients. AIDS. 2013; 27(8): 1283-93.

Problems of Virology. 2018; 63: 261-267

MESENCHYMAL STEM CELLS ENHANCE IMMUNE RESPONSE AND PROTECTMICE AGAINST LETHAL HERPES VIRAL INFECTION

Klimova R. R., Momotyuk E. D., Demidova N. A., Yarigina E. I., Kushch A. A.

https://doi.org/10.18821/0507-4088-2018-63-6-261-267

Abstract

The objective of this study was to evaluate immunoregulatory and protective potential of mesenchymal stem cells (MSC) in a mouse model of lethal HSV1 infection. MSC were isolated from bone marrow of DBA mice and cultured in flasks with DMEM containing 10% FBS, insulin, transferrin, selenite, fibroblast growth factor, glutaminе and gentamicin. Antiviral activity was tested on HSV1-infected Vero cells. In vivo experiments were performed on DBA mice divided into 5 groups (10 animals each): group 1, intact (naïve) mice; group 2, intravenous (iv) MSC injection; group 3, intraperitoneal infection with 20 LD50 HSV1 followed by MSC injection; group 4, HSV1 infection followed by acyclovir (ACV) injection; group 5, HSV1 infection and iv injection of saline. Isolated cells were consistent with MSC morphologically, by adhesive ability and surface receptors. Conditioned media from MSC collected after 4-5 passages inhibited HSV1 infection in vitro by 64-70% and contained IL-6 and TNF-α, whose concentrations were 5- and 20-fold higher, respectively, than in the control. MSC and ACV injections protected 70% and 60% of DBA mice, respectively, compared with the control (group 5, 10% survival). High activity of virus neutralizing anti-HSV1 antibodies and activation of T cell proliferation were observed in survived mice from group 3. Serum levels of IL-6 and TNF-α in these mice were lower and that of INF-γ much higher than in agonizing animals of this group (Р<0.05). These findings indicate that MSC therapy is a prospective approach to the development of new effective management of generalized HSV1 infection.
References

1. Arduino P.G., Porter S.R. Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features. J. Oral. Pathol. Med. 2008; 37(2): 107-21.

2. Looker K.J., Magaret A.S., May M.T., Turner K.M., Vickerman P., Gottlieb S.L., et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One. 2015; 10(10): e0140765.

3. James S.H., Kimberlin D.W. Neonatal Herpes Simplex Virus Infection. Infect. Dis. Clin. North Am. 2015; 29(3): 391-400.

4. Ruffner M.A., Sullivan K.E., Henrickson S.E. Recurrent and Sustained Viral Infections in Primary Immunodeficiencies. Front. Immunol. 2017; 8: 665.

5. Ma S., Xie N., Li W., Yuan B., Shi Y., Wang Y. Immunobiology of mesenchymal stem cells. Cell Death Differ. 2014; 21(2): 216-25.

6. Rohban R., Pieber T.R. Mesenchymal Stem and Progenitor Cells in Regeneration: Tissue Specificity and Regenerative Potential. Stem Cells Int. 2017; 2017: 5173732.

7. Rivera-Cruz C.M., Shearer J.J., Figueiredo Neto M., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: e4015039.

8. Darwish I., Banner D., Mubareka S., Kim H., Besla R., Kelvin D.J., et al. Mesenchymal stromal (stem) cell therapy fails to improve outcomes in experimental severe influenza. PLoS One. 2013; 8(8): e71761.

9. Li Y., Xu J., Shi W., Chen C., Shao Y., Zhu L., et al. Mesenchymal stromal cell treatment prevents H9N2 avian influenza virus-induced acute lung injury in mice. Stem Cell. Res. Ther. 2016; 7(1): 159.

10. Klimova R.R., Momotyuk E.D., Demidova N.A., Chernoryzh Ya.Yu., Koval' V.S., Ivanov A.A. i dr. Dimernye bisbenzimidazoly podavlyayut infektsii, vyzvannye virusom prostogo gerpesa i tsitomegalovirusom cheloveka, v kletochnykh kul'turakh. Voprosy virusologii. 2017; 62(4): 162-8

11. Dominici M., LeBlanc K., Mueller I., Slaper-Cortenbach I., Marini F., Krause D., et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006; 8(4): 315-7.

12. Ellermann-Eriksen S. Macrophages and cytokines in the early defence against herpes simplex virus. Virol. J. 2005; 2: 59.

13. Riediger C., Sauer P., Matevossian E., Müller M.W., Büchler P., Friess H. Herpes simplex virus sepsis and acute liver failure. Clin. Transpl. 2009; 23(Suppl. 21): 37-41.

14. Rozenberg F., Deback C., Agut H. Herpes simplex encephalitis: from virus to therapy. Infect. Disord. Drug Targets. 2011; 11(3): 235-50.

15. Cagliani J., Grande D., Molmenti E.P., Miller E.J., Rilo H.L.R. Immunomodulation by Mesenchymal Stromal Cells and Their Clinical Applications. J. Stem Cell Regen. Biol. 2017; 3(2).

16. Kyurkchiev D., Bochev I., Ivanova-Todorova E., Mourdjeva M., Oreshkova T., Belemezova K., et al. Secretion of immunoregulatory cytokines by mesenchymal stem cells. World J Stem Cells. 2014; 6(5): 552-70.

17. Whitley R. J. Herpes Simplex Viruses. In: Knipe D.M., Howley P.M., eds. Fields Virology. Volume 2. Philadelphia, PA: Lippincott Williams and Wilkins; 2001: 2461-509.

18. Di Nicola M., Carlo-Stella C., Magni M., Milanesi M., Longoni P.D., Matteucci P., et al. Human bone marrow stromal cells suppress T-lymphocyte proliferation induced by cellular or nonspecific mitogenic stimuli. Blood. 2002; 99(10): 3838-43.

19. Rosado M.M., Bernardo M.E., Scarsella M., Conforti A., Giorda E., Biagini S., et al. Inhibition of B-cell proliferation and antibody production by mesenchymal stromal cells is mediated by T cells. Stem Cells Dev. 2015; 24(1): 93-103.

20. Rivera-Cruz C.M., Shearer J.J., Neto M.F., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: 4015039.

21. Bian P., Ye C., Zheng X., Yang J., Ye W., Wang Y., et al. Mesenchymal stem cells alleviate Japanese encephalitis virus-induced neuroinflammation and mortality. Stem Cell Res Ther. 2017; 8(1): 38.

22. Chan M.C., Kuok D.I., Leung C.Y., Hui K.P., Valkenburg S.A., Lau E.H., et al. Human mesenchymal stromal cells reduce influenza A H5N1-associated acute lung injury in vitro and in vivo. Proc. Natl. Acad. Sci. 2016; 113(13): 3621-6.

23. Zhang Z., Fu J., Xu X., Wang S., Xu R., Zhao M., et al. Safety and immunological responses to human mesenchymal stem cell therapy in difficult-to-treat HIV-1-infected patients. AIDS. 2013; 27(8): 1283-93.

24. Arduino P.G., Porter S.R. Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features. J. Oral. Pathol. Med. 2008; 37(2): 107-21.

25. Looker K.J., Magaret A.S., May M.T., Turner K.M., Vickerman P., Gottlieb S.L., et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One. 2015; 10(10): e0140765.

26. James S.H., Kimberlin D.W. Neonatal Herpes Simplex Virus Infection. Infect. Dis. Clin. North Am. 2015; 29(3): 391-400.

27. Ruffner M.A., Sullivan K.E., Henrickson S.E. Recurrent and Sustained Viral Infections in Primary Immunodeficiencies. Front. Immunol. 2017; 8: 665.

28. Ma S., Xie N., Li W., Yuan B., Shi Y., Wang Y. Immunobiology of mesenchymal stem cells. Cell Death Differ. 2014; 21(2): 216-25.

29. Rohban R., Pieber T.R. Mesenchymal Stem and Progenitor Cells in Regeneration: Tissue Specificity and Regenerative Potential. Stem Cells Int. 2017; 2017: 5173732.

30. Rivera-Cruz C.M., Shearer J.J., Figueiredo Neto M., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: e4015039.

31. Darwish I., Banner D., Mubareka S., Kim H., Besla R., Kelvin D.J., et al. Mesenchymal stromal (stem) cell therapy fails to improve outcomes in experimental severe influenza. PLoS One. 2013; 8(8): e71761.

32. Li Y., Xu J., Shi W., Chen C., Shao Y., Zhu L., et al. Mesenchymal stromal cell treatment prevents H9N2 avian influenza virus-induced acute lung injury in mice. Stem Cell. Res. Ther. 2016; 7(1): 159.

33. Klimova R.R., Momotyuk E.D., Demidova N.A., Chernoryzh Ya.Yu., Koval’ V.S., Ivanov A.A., et al. Dimeric bisbenzimidazoles suppress the herpes simplex virus and human cytomegalovirus infections in the cells in vitro. Voprosy virusologii. 2017; 62(4): 162-8. (in Russian)

34. Dominici M., LeBlanc K., Mueller I., Slaper-Cortenbach I., Marini F., Krause D., et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006; 8(4): 315-7.

35. Ellermann-Eriksen S. Macrophages and cytokines in the early defence against herpes simplex virus. Virol. J. 2005; 2: 59.

36. Riediger C., Sauer P., Matevossian E., Müller M.W., Büchler P., Friess H. Herpes simplex virus sepsis and acute liver failure. Clin. Transpl. 2009; 23(Suppl. 21): 37-41.

37. Rozenberg F., Deback C., Agut H. Herpes simplex encephalitis: from virus to therapy. Infect. Disord. Drug Targets. 2011; 11(3): 235-50.

38. Cagliani J., Grande D., Molmenti E.P., Miller E.J., Rilo H.L.R. Immunomodulation by Mesenchymal Stromal Cells and Their Clinical Applications. J. Stem Cell Regen. Biol. 2017; 3(2).

39. Kyurkchiev D., Bochev I., Ivanova-Todorova E., Mourdjeva M., Oreshkova T., Belemezova K., et al. Secretion of immunoregulatory cytokines by mesenchymal stem cells. World J Stem Cells. 2014; 6(5): 552-70.

40. Whitley R. J. Herpes Simplex Viruses. In: Knipe D.M., Howley P.M., eds. Fields Virology. Volume 2. Philadelphia, PA: Lippincott Williams and Wilkins; 2001: 2461-509.

41. Di Nicola M., Carlo-Stella C., Magni M., Milanesi M., Longoni P.D., Matteucci P., et al. Human bone marrow stromal cells suppress T-lymphocyte proliferation induced by cellular or nonspecific mitogenic stimuli. Blood. 2002; 99(10): 3838-43.

42. Rosado M.M., Bernardo M.E., Scarsella M., Conforti A., Giorda E., Biagini S., et al. Inhibition of B-cell proliferation and antibody production by mesenchymal stromal cells is mediated by T cells. Stem Cells Dev. 2015; 24(1): 93-103.

43. Rivera-Cruz C.M., Shearer J.J., Neto M.F., Figueiredo M.L. The Immunomodulatory Effects of Mesenchymal Stem Cell Polarization within the Tumor Microenvironment Niche. Stem Cells Int. 2017; 2017: 4015039.

44. Bian P., Ye C., Zheng X., Yang J., Ye W., Wang Y., et al. Mesenchymal stem cells alleviate Japanese encephalitis virus-induced neuroinflammation and mortality. Stem Cell Res Ther. 2017; 8(1): 38.

45. Chan M.C., Kuok D.I., Leung C.Y., Hui K.P., Valkenburg S.A., Lau E.H., et al. Human mesenchymal stromal cells reduce influenza A H5N1-associated acute lung injury in vitro and in vivo. Proc. Natl. Acad. Sci. 2016; 113(13): 3621-6.

46. Zhang Z., Fu J., Xu X., Wang S., Xu R., Zhao M., et al. Safety and immunological responses to human mesenchymal stem cell therapy in difficult-to-treat HIV-1-infected patients. AIDS. 2013; 27(8): 1283-93.